Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 28, 2024
Open Peer Review Period: Jul 4, 2024 - Aug 29, 2024
Date Accepted: Jan 29, 2026
(closed for review but you can still tweet)
App-based training module on guiding physicians’ prescription for antibiotic treatment of gonorrhoea in China: cluster-randomised controlled trial
ABSTRACT
Background:
High prevalence of physicians’ non-adherence to treatment recommendations for gonorrhoea is a concern in China and poor awareness of treatment recommendations has been documented as one of reasons for the non-adherence.
Objective:
To assess the impact of an App-based training tool on improvement of adherence to treatment recommendations for gonorrhoea in China.
Methods:
We did a cluster-randomised controlled trial. Clusters were hospitals from four provinces in China. We randomly allocated each hospital to receive an App-based training module (ATM) or continue the routine of training (ROT). In ATM hospitals, physicians were offered a free App-based training through their smartphones for access to the training anytime (intervention) for 6 months. In ROT hospitals, physicians participated in any training programmes as they routinely did (control). The primary outcome was comparison of changes in adherence rate between ATM and ROT. The secondary outcome was reasons for physicians to explain their non-adherence.
Results:
Among 72 hospitals from the 4 provinces (18 hospitals of each province), 36 each received ATM and ROT, respectively. Over 6 months, the adherence rate increased from 53.6% to 54.8% in ATM group while the rate decreased from 43.9% to 42.5% in ROT. The difference (5.5%, 95% CI -7-18, P=0.37) in changes of the adherence rate between ATM and ROT was not statistically significant (risk ratio 1.12, 95% CI 0.93- 1.35, P=0.23). A major reason for physicians’ non-adherence to the treatment recommendations was a concern on adequacy of the recommended dosage of currently available generic format of ceftriaxone for treatment of gonorrhoea in China.
Conclusions:
The findings indicate that sizeable improvement of adherence to the treatment recommendations through an App-based training tool might not be achievable over a 6-month period if concern on effectiveness of generic medicine still exits. Clinical Trial: https://www.chictr.org.cn/ ChiCTR2000029591
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